AHA letter to editor: Site-neutral payment policies fail to account for site differences

In a letter to the editor published Aug. 1 in the Wall Street Journal, AHA President and CEO Rick Pollack responds to a recent op-ed by former Louisiana Gov. Bobby Jindal and the Center for a Healthy America at the America First Policy Institute, which advocated for site-neutral payment policies for outpatient care. 
 
“So-called ‘site-neutral’ policies fail to account for the differences between hospital outpatient departments (HOPDs) and other sites of care,” Pollack writes. “HOPDs treat sicker, lower-income Medicare patients and those dually eligible for Medicare and Medicaid, with more complex and chronic conditions than those treated in independent physician offices or ambulatory surgery centers. HOPDs are also required to comply with many more regulatory and safety codes and provide 24/7 standby capacity for emergencies. It’s appropriate that they be provided with differential payment.
 
“Existing site-neutral payment policies have already hurt hospitals. Under current law, the vast majority of off-campus HOPDs that weren’t billing Medicare before November 2015 are already paid at a site-neutral rate.
 
“Health insurers and private-equity firms, not hospitals, are responsible for most of the acquisition of physicians during the past five years. As polling has shown, most physicians are choosing to become employed rather than operate their own practices due to increased costs and burden from policies like commercial insurer prior authorizations.”